Legislature(2023 - 2024)BARNES 124

04/08/2024 03:15 PM House LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 309 DELEGATION OF ROUTINE OPTOMETRY SERVICES TELECONFERENCED
Heard & Held
-- Public Testimony --
+ HB 394 RCA REGULATE NATURAL GAS STORAGE FACILITY TELECONFERENCED
Scheduled but Not Heard
+ HB 187 PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS TELECONFERENCED
<Pending Referral>
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 378 ORG. RETAIL THEFT/FUND;MKTPLACE SALES TAX TELECONFERENCED
<Bill Hearing Canceled>
+= HB 313 PUBLIC UTILITY REGULATORY COST CHARGE TELECONFERENCED
Heard & Held
+= HB 55 EXTEND WORKFORCE INVEST BOARD ALLOCATIONS TELECONFERENCED
Moved HB 55 Out of Committee
+= SB 147 WORKERS' COMP.; EXTND SR BENEFITS PAYMENT TELECONFERENCED
Heard & Held
        HB 309-DELEGATION OF ROUTINE OPTOMETRY SERVICES                                                                     
                                                                                                                                
3:53:34 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced that the  final order of business would be                                                               
HOUSE  BILL  NO.  309,  "An  Act  relating  to  the  practice  of                                                               
optometry; and relating to the  delegation of routine services of                                                               
optometry."                                                                                                                     
                                                                                                                                
3:54:14 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease at 3:55 p.m.                                                                                      
                                                                                                                                
[Chair Sumner passed the gavel to Representative Wright.]                                                                       
                                                                                                                                
3:55:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE,  prime sponsor,  presented HB 309.   He                                                               
said the  bill is a  simple update  to the optometry  practice to                                                               
allow the  delegation of  certain duties  to an  assistant within                                                               
the practice.   He  described the  update as  a necessary  one to                                                               
match current optometry business practices.                                                                                     
                                                                                                                                
3:55:57 PM                                                                                                                    
                                                                                                                                
JAMES  SEXTON,  Staff,  Representative Justin  Ruffridge,  Alaska                                                               
State Legislature,  on behalf of Representative  Ruffridge, prime                                                               
sponsor,  gave  a  PowerPoint   presentation,  entitled  "HB  309                                                               
Optometry  Practices"  [hard  copy   included  in  the  committee                                                               
packet].   He began on  slide 2,  "Issue," which read  as follows                                                               
[original punctuation provided]:                                                                                                
                                                                                                                                
     •  Optometric practices  do  not  have current  statute                                                                    
     language to  allow the Board of  Examiners of Optometry                                                                    
     to regulate  delegation of routine tasks  to Optometric                                                                    
     Technicians and Assistants                                                                                                 
     •  Delegation  of  basic  routine  tasks  are  standard                                                                    
     practice  in  other   health  professions  licensed  in                                                                    
     Alaska, as well as optometric practices nationwide                                                                         
     •  Without   this  authority,  Optometrists   would  be                                                                    
     required  to  perform  all  preliminary  and  ancillary                                                                    
     testing on  each patient, which would  greatly restrict                                                                    
     access to care.                                                                                                            
                                                                                                                                
MR. SEXTON  continued to slide  3, "Other  Healthcare professions                                                               
in  Alaska,"   which  read   as  follows   [original  punctuation                                                               
provided]:                                                                                                                      
                                                                                                                                
     • Professions  in Alaska that have  solved this problem                                                                    
     with incorporating delegation authority include:                                                                           
     •  Medical  Doctors,  Doctor of  Osteopathic  Medicine,                                                                    
     Podiatry, Physician Assistants (08.64.106)                                                                                 
     • Dental (08.32.346)                                                                                                       
     • Veterinary (08.98.050 (9,B))                                                                                             
     • Pharmacy (08.80.030,(9))                                                                                                 
     • Chiropractic (08.20.168)                                                                                                 
                                                                                                                                
MR.  SEXTON advanced  to slide  4, "Examples  of routine  tasks,"                                                               
which read as follows [original punctuation provided]:                                                                          
                                                                                                                                
     • Initial patient medical history  and reason for visit                                                                    
     •   Initial   assessment    of   vision   and   current                                                                    
     prescription verification                                                                                                  
     • Blood pressure  screenings and automated measurements                                                                    
     of the eye                                                                                                                 
     • Ocular photography and digital  imaging for review by                                                                    
     the doctor                                                                                                                 
     • Assisting in medication refills                                                                                          
     •    Performing   peripheral    vision   testing    for                                                                    
     interpretation by the doctor                                                                                               
                                                                                                                                
MR. SEXTON  turned to slide  5, "Current challenges,"  which read                                                               
as follows [original punctuation provided]:                                                                                     
                                                                                                                                
     •  In the  absence of  the ability  to delegate  tasks,                                                                    
     Optometry  will  be  less efficient  and  effective  at                                                                    
     meeting the demand  of patient care that  exists in the                                                                    
     state currently.                                                                                                           
     • Optometry is projected to grow in the future.                                                                            
     • Adding  a logistical and financial  burden to current                                                                    
     and future Optometrists may  contribute to the shortage                                                                    
     of healthcare professionals.                                                                                               
                                                                                                                                
MR. SEXTON proceeded to slide 6,  "HB 309 Impacts," which read as                                                               
follows [original punctuation provided]:                                                                                        
                                                                                                                                
     • This  bill will have  no impact on  billing practices                                                                    
     and will not increase  costs to the patient population.                                                                    
     • The  impact of  passing this bill  will be  to ensure                                                                    
     that  patients  continue  to  receive  appropriate  and                                                                    
     effective  care   supervised  by   licensed  Optometric                                                                    
     Physicians in Alaska.                                                                                                      
                                                                                                                                
MR.  SEXTON  concluded  on  slide 7,  "Support,"  which  read  as                                                               
follows [original punctuation provided]:                                                                                        
                                                                                                                                
        The  Alaska  Optometric  Association  supports  this                                                                    
     legislative approach and action.                                                                                           
     • HB 309 brings Optometrists  in line with other health                                                                    
     related professions in Alaska.                                                                                             
                                                                                                                                
3:59:46 PM                                                                                                                    
                                                                                                                                
BRADLEY  CROSS,  Chair, Board  of  Examiners  in Optometry,  gave                                                               
invited testimony  during the hearing  on HB  309.  He  said that                                                               
optometry is  responsible for maintaining  the eye health  of all                                                               
Alaskans, adding that the  profession is economically beneficial,                                                               
sustainable,  and  good   for  Alaska.    He  said   that  it  is                                                               
commonplace  elsewhere in  the world  for technicians  to perform                                                               
duties  to  free up  the  time  of  optometrists, and  that  this                                                               
legislation would  ensure that optometrists  have the  backing of                                                               
our state  statutes when they  relegate tasks to  technicians and                                                               
assistants in  the practice.   He  said that  the State  Board of                                                               
Optometry is prepared to spell  out guidelines for the regulatory                                                               
implementation of HB 309.                                                                                                       
                                                                                                                                
4:04:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  asked  how  to define  an  agent  of  an                                                               
optometrist.                                                                                                                    
                                                                                                                                
MR.  CROSS said  the  role of  "optometric  technician" would  be                                                               
defined in regulation.                                                                                                          
                                                                                                                                
REPRESENTATIVE SADDLER sought  to confirm that an  agent would be                                                               
an optometric technician, which would be defined by regulation.                                                                 
                                                                                                                                
MR.  CROSS said  "what  they would  be allowed  to  do" would  be                                                               
defined in regulation.                                                                                                          
                                                                                                                                
REPRESENTATIVE   SADDLER  asked   how  the   board  might   draft                                                               
regulations to specify an agent of optometry's role.                                                                            
                                                                                                                                
MR.  CROSS said  the agent  would  be defined  as the  optometric                                                               
technician  and  the  assistant to  the  optometrist.    Required                                                               
training and oversight would also be defined.                                                                                   
                                                                                                                                
4:05:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CARRICK  asked whether optometrists  are currently                                                               
required to work within the practice of an ophthalmologist.                                                                     
                                                                                                                                
MR. CROSS answered no.  In  addition to a follow up question from                                                               
Representative  Carrick,  he  explained that  eye  care  provided                                                               
outside the scope of optometry would not be addressed by HB 309.                                                                
                                                                                                                                
REPRESENTATIVE RUFFRIDGE, in  response to Representative Carrick,                                                               
he explained that an optometrist could delegate a machine-                                                                      
driven,  routine  service in  a  rural  community to  an  on-site                                                               
technician  and analyze  the results  remotely with  a telehealth                                                               
visit.                                                                                                                          
                                                                                                                                
REPRESENTATIVE  CARRICK inquired  about  the  restrictions on  an                                                               
optometrist providing remote telehealth services.                                                                               
                                                                                                                                
REPRESENTATIVE RUFFRIDGE said that is  some of the impetus behind                                                               
this bill, as  the board has been unable to  draft regulations to                                                               
address that question.                                                                                                          
                                                                                                                                
MR.  CROSS  agreed  that telehealth  would  necessitate  that  an                                                               
optometry licensee  be supervising  an optometric assistant.   He                                                               
noted  that  the board  has  precluded  complete eye  exams  with                                                               
determination   of  a   refraction  from   being  performed   via                                                               
telehealth.     Consequently,   the   telehealth  component   for                                                               
optometry  would  be consultation  and  follow  up more  so  than                                                               
ancillary testing.                                                                                                              
                                                                                                                                
4:10:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SADDLER   asked   whether  there   is   national                                                               
certification for optometric technicians.                                                                                       
                                                                                                                                
MR. CROSS  answered yes, the American  Optometric Association has                                                               
created a program and guidelines for that certification.                                                                        
                                                                                                                                
REPRESENTATIVE  SADDLER  asked   whether  national  certification                                                               
should  be  a regulatorily  defined  requirement  for someone  to                                                               
function as an optometric technician.                                                                                           
                                                                                                                                
MR. CROSS said  while it would be valuable,  most technicians are                                                               
trained on the  job so the requirement would be  unnecessary.  In                                                               
response to  a follow up  question, he  said passage of  the bill                                                               
would prevent increased costs for patients.                                                                                     
                                                                                                                                
4:12:26 PM                                                                                                                    
                                                                                                                                
ELIZABETH   STEVENS,   Executive  Director,   Alaska   Optometric                                                               
Association (AKOA), gave invited testimony  in support of HB 309,                                                               
which would  grant the  board the  authority to  draft regulation                                                               
regarding  the delegation  of routine  optometric services.   She                                                               
said the AKOA strongly supports the bill.                                                                                       
                                                                                                                                
4:13:44 PM                                                                                                                    
                                                                                                                                
DAMIEN  DELZER,  President-Elect, Alaska  Optometric  Association                                                               
(AKOA),  gave  invited  testimony  in  support of  HB  309.    He                                                               
explained that  HB 309 is  legislation requested by the  Board of                                                               
Examiners in  Optometry due  to the statute  being outdated.   He                                                               
said  that it  is industry  standard for  optometry practices  to                                                               
relegate tasks  to technicians and  associates, and HB  309 would                                                               
bring Alaska up to  speed with the rest of the  country.  He said                                                               
the bill would would reduce  demand on optometrists and free them                                                               
up  for  consultation  and  treatment.     It  would  also  allow                                                               
technicians to  provide assistance  to optometrists  via statute.                                                               
He emphasized the AKOA's strong support for HB 309.                                                                             
                                                                                                                                
4:17:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER questioned  the value  of using  national                                                               
certification as a qualifier for providing optometric services.                                                                 
                                                                                                                                
MR.  DELZER reiterated  that most  optometric assistance  receive                                                               
training on  the job and  would have  the opportunity to  sit for                                                               
various levels  of examinations given by  the American Optometric                                                               
Association   to  obtain   additional   qualifications  as   they                                                               
progress.    Ultimately,  he  opined   that  using  the  national                                                               
certification as a prerequisite would be a barrier.                                                                             
                                                                                                                                
REPRESENTATIVE  SADDLER asked  whether the  examinations for  the                                                               
national certifications occur every year or level by level.                                                                     
                                                                                                                                
MR.  DELZER said  the American  Optometric  Association has  four                                                               
levels  of  examination  for paraoptometric  certification.    In                                                               
response to a follow up  question, he confirmed that a technician                                                               
who  received increasing  levels of  certification would  receive                                                               
higher levels of compensation.                                                                                                  
                                                                                                                                
4:20:57 PM                                                                                                                    
                                                                                                                                
CHAIR  WRIGHT  opened   public  testimony  on  HB   309.    After                                                               
ascertaining  that no  one wished  to testify,  he closed  public                                                               
testimony and announced that the bill would be held over.                                                                       

Document Name Date/Time Subjects
HB 309 presentation.pdf HL&C 4/8/2024 3:15:00 PM
HB 309
HB 309- support as of 4.724.pdf HL&C 4/8/2024 3:15:00 PM
HB 309
HB 309 AAO Letter_AK_House Labor & Commerce.pdf HL&C 4/8/2024 3:15:00 PM
HB 309
HB 309 Sectional Analysis.pdf HL&C 4/8/2024 3:15:00 PM
HB 309
HB 309 Sponsor Statement.pdf HL&C 4/8/2024 3:15:00 PM
HB 309
HB 309 fiscal note DCCED_Coprs,Businesses, Prof licensing as of 3.15.24.pdf HL&C 4/8/2024 3:15:00 PM
HB 309
HB 309- Memo regarding Delegation Authority.pdf HL&C 4/8/2024 3:15:00 PM
HB 309
HB226 Version U (CS for HLC).pdf HL&C 4/8/2024 3:15:00 PM
HB 226
HB226 Explanation of Changes Ver. S to Ver. U.pdf HL&C 4/8/2024 3:15:00 PM
HB 226